Radiology · patient case question
Which extraoral projection best demonstrates the maxillary sinuses?
Patient case: Reading the panoramic film
demo: Series of radiographic interpretation items
chief: Assorted radiographic findings and technique errors from a single clinic session.
history: Several patients imaged the same morning; the films are reviewed together at the end of the day.
meds: Not applicable.
findings: One panoramic film shows the right ramus and posterior teeth appreciably wider than the left. Another shows two ring-shaped radiopacities superimposed over one maxillary sinus and three over the other, in a patient wearing earrings. A third shows a curved radiopacity in the lower field. An occlusal film shows a soft tissue shadow over the incisal edges of the anterior teeth.
Show answer and explanation
Correct answer: D. Waters projection
- A. The submentovertex, or base, view shows the zygomatic arches and the skull base from below, and is used for medial or lateral displacement of the arches.
- B. A lateral cephalometric film superimposes the two sides and is used for orthodontic and orthognathic analysis, not for sinus assessment.
- C. The reverse Towne view is used for condylar neck fractures and demonstrates the condyles and the posterior skull.
- D. Correct. The Waters, or occipitomental, projection tips the head so the petrous ridges drop below the antral floors, giving an unobstructed view of both maxillary sinuses. It is the standard plain film for sinusitis and for orbital floor and midface fractures.